BLOODBORNE PATHOGENS

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Objectives:

Identify five classes of microorganisms by describing their characteristics

List six components of the chain of infection

Differentiate between antisepsis, disinfect ion and sterilization

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Basic Understanding of Infection Control

Normal FloraNonpathogensPathogensVirulenceHostHealth Care Workers need to know how diseases are transmitted and avoid being the link to further transmission.

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Bacteria

Cocci are round, one celled plants classified according to shape and arrangement.

Diplococci are arranged in pairs

Examples:Gonorrhea, Meningitis and Pneumonia

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Streptococci are spherical bacteria arranged in chains:

Examples: Strept. throat, Scarlet Fever,Rheumatic Fever

Staphlococci are clusters of cocci.

Examples: Wound infections, Impetigo, Toxic Shock Syndrome. Often causing purulent material to be formed.

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OTHER BACTERIABACILLI (RODS) are large,rod-shaped cellsFound singly or in groupsExamples Anthrax, Salmonella, TB,Tetanus, Typhoid

SPIRILLA are curved or spiral bacteria That are arranged singly or in colonies.Examples: Campylobacter, Syphilis, Lyme Disease

ANTIBIOTIC ARE OFTEN EFFECTIVE AGAINST A BACTERIAL INFECTION

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Another version of Bacteria: RICKETTSIA

Rickettsia species are small, Gram-negative bacilli that are obligate intracellular parasites. Called “oblate” because they can reproduce only inside other living cells.Examples: Rocky Mountain Spotted Fever, Chlamydia,

The Lone Star tick, Amblyomma americanum, a common, human-biting tick.

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OTHER PATHOGENS:PROTOZOA are complex one-celled animals that can live in human fluids and cause disease. Many have flagella.Examples: Giardia (Travelers Diarrhea) Trichomonas, Malaria

Fungi are simple plants but without chlorophyll. Yeast and mold are types Fungi. They must parasitize as they cannot make food.Examples; Candida (Thrush), Tinea(Ringworm),

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Viruses

Viruses are intracellular parasites that consist of a DNA or RNA core surrounded by a protein coat and sometimes a lipoprotein envelope. They invade cells and insert theirown genetic code into the host. Thus, the pirate the hosts nutrients and organelles, multiply and infect other cells.Examples: Cold, Influenza, West Nile Virus, Avian Flu, Polio,Mono, Measles, Mumps, HBV,HCV, HIV.

                                                  

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Hepatitis A

• Not bloodborne

• Severity of disease

• Poor sanitation

• Raw seafood

• Daycare centers

• VaccineDHO UNIT 13:1-13:3

Hepatitis B

• Most common occupationally-acquired infection

• Blood borne, sexual contact and perinatal

• Virus attack livers and can cause lifelong

infection, cirrhosis of the liver, liver cancer,

liver failure and death.

• Vaccine available. Required by OSHA.DHO UNIT 13:1-13:3

Hepatitis B

Found in:

• Blood

• Vaginal Secretions

• Semen

• Saliva

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Signs and Symptoms:• Nausea

• Lack of appetite

• Fatigue

• Joint pain

• Dark urine

• Jaundice

• FeverDHO UNIT 13:1-13:3

Hepatitis C• The hepatitis C virus (HCV) is a blood-borne

virus that was previously referred to as

non-A/non-B hepatitis

•As many as 80-85% of people initially infected

with HCV may become chronically infected

•No vaccine available

•Today HCV is the leading reason for liver transplants

Bloodborne Pathogens Division of Safety & Hygiene

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Hepatitis D

A defective virus that needs the HBV to exist

Co-infection with HBVChronic liver disease with cirrhosis,

liver cancer, and fulminant hepatitis also possible.

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HIV• HIV infection is a viral infection caused by the human immunodeficiency virus (HIV) that gradually destroys the immune system, resulting in infections that are hard for the body to fight.

• People who become infected with HIV may have no symptoms for up to 10 years, but they can still transmit the infection to others.

• No vaccine, no cure

• Risk to Health care workers

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HIV Signs & Symptoms

• Night sweats

• Fever, chills

• Joint Pain

•Swollen glands

• Flu-like

• Fatigue

• Rash

(many have all, none, or some)

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Factors required for growth

WarmMoist DarkAerobic require oxygen to liveAnerobic live and reproduce without oxygen

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CLASSIFICATIONS OF DISEASES AND INFECTIONS

ENDOGENOUS

EXOGENOUS

NOSOCOMIAL

OPPORTUNISTIC

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The Chain of Infection

Reservoir Host

Portal of Exit

Mode of TransmissionPortal of Entry

Susceptible Host

Infectious Agent

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As healthcare As healthcare professionals, it professionals, it is important tois important to understand two understand two things about things about infectioninfection:

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1.The various ways infection can be transmitted

2. The ways the infection chain can be broken

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There are six There are six links links in the Chain of in the Chain of Infection Infection ::

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11stst- Causative Agent- Causative Agent

-Any disease-causing microorganism (pathogen)

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2nd - The Reservoir Host2nd - The Reservoir Host

-The organism in which the infectious microbes reside. -Common reservoirs are: human body, vectors, fomites, & environment.

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Hosts that do not show any outward signs or symptoms of a disease but are still capable of transmitting the disease are known as carriers.

What are “Carrier Hosts”What are “Carrier Hosts”

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3rd - The Portal of Exit3rd - The Portal of Exit

-Route of escape of the pathogen from the reservoir.

Examples: respiratory secretions, blood, urine, feces, sexual secretions, wound drainage.

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4th - The Route of 4th - The Route of TransmissionTransmission

-Method by which the pathogen gets from the reservoir to the new host

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Transmission may occur through:

Direct Contact: Person-to-Person…contaminated hands are the most common

What other means of direct transmission are What other means of direct transmission are there?there? DHO UNIT 13:1-13:3

Air

Indirect Contact: as in Indirect Contact: as in the case of inanimate objects the case of inanimate objects transmitting the pathogen. Such transmitting the pathogen. Such as:as:

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InsectsVector: animal or insect that transmits the pathogen from infected to noninfectied individuals.

Can you think of others?Can you think of others?DHO UNIT 13:1-13:3

5th - The Portal of Entry5th - The Portal of Entry

-Route through which the pathogen enters its new host

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Respiratory System

inhala

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inhala

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Gastrointestinal Systemin

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Urinary & Reproductive TractsSex

ual

Sexua

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tact

cont

act

Or across Or across the the placentaplacenta

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Breaks in Protective Skin BarrierAka: nonintact skin

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6th - The6th - The Susceptible Susceptible HostHost

-The organism that accepts the pathogen

The support of pathogen life & its reproduction depend on the degree of the host’s resistance.

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-The essential part of patient care & self-protection.

How to interrupt the Chain of Infection:How to interrupt the Chain of Infection:

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Remember--breaking the chain of Remember--breaking the chain of infection is the responsibility infection is the responsibility of each health professional.of each health professional.

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ASEPTIC CONTROL ASEPSIS

CONTAMINATED

ANTISEPSIS

DISINFECTION

STERILIZATION

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Exposure Control

Bloodborne Pathogens Division of Safety & Hygiene

UNIT 13:2

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OBJECTIVES FOR 13:2 AND 13:3Recognize need for and demonstrate Handwashing

Identify need for and demonstrate standard precautions

Potentially Infectious MaterialsBlood Mucus

Semen Vaginal Secretions

Sputum Saliva

Other Body fluids “Visible soiled” objects

Tissue/Cell specimens Mucous Membranes

Non-intact skin

“IF IT IS WET AND FROM THE BODY, CONSIDER IT INFECTIOUS”…..better safe than sorry.

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Universal Precautions

An approach to infection control. All

human blood and certain body fluids are

treated as if known to be infectious.

STANDARD PRECAUTIONS: are the rules

designed to protect the patient and HCW

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Methods of Control

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Indications for Hand Hygiene

When hands are visibly soiled Before and after each patient Before and after each procedure Before you eat As you begin your shift After you use the restroom Before and after you use

glovesBefore and after handling a specimen

Methods of Control (Cont.)

Hand sanitizers with 60% or more alcohol are very effective.

• Always wash hands:

•Visibly contaminated

•After using bathroom

•Before you eat

•When hands feel “sticky”

• Pathogens that are spores ( C-Difficile)

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Gloves

• Disposable - not reused

• Change if torn or punctured

• Awareness of latex allergic reactions

• Use of utility gloves

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PPESyringes with protection devices

Gloves with choices to avoid latex

Masks with various filters (e.g N95)

Face Shields

Biohazard symbol to warn of body fluid

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Exposure Incident

A specific eye, mouth, or other

mucous membrane, non-intact skin

or parenteral contact with blood or

other potentially infectious material

that results from the performance of

an employee’s duties.

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Post-exposure follow-up

• Definition of “exposure”

• Selecting medical service

• Informing the employee

• Recordkeeping

• Confidentiality of results

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Blood spill clean-up

• Use correct “–cidal”

• Follow “wait” time

• Performed by someone with HBV

vaccine

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http://www.youtube.com/watch?v=-_kwXNVCaxY